Cultured human keratocytes display many ultrastructural features of in situ keratocytes. These features are still present after reculture after cryopreservation. Cryopreservation induces necrosis in a small percentage of cells, which seems to be related to a relative lack of cell-membrane protection by the cryoprotectants used.
An outbreak of coronavirus disease 2019 , now known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that began in China in December 2019, has since spread rapidly throughout the world. 1 There are several reports of hemodialysis patients with COVID-19. [2][3][4] Hemodialysis patients appear to be a population at high risk for severe COVID-19, because factors identified as risk factors for severe COVID-19 are often present in these patients: old age, hypertension, cardiovascular comorbidity, and diabetes mellitus. In addition, these patients also show impaired antiviral immune responses, because of the impaired kidney function. On the other hand, hemodialysis patients may not be at a higher risk for more severe COVID-19 in other respects: They are also aware of their vulnerable condition, they know that they should seek medical advice immediately when they have fever or other complaints, and they have an immunosuppressed state which may attenuate the hyperinflammatory response observed in the stage of severe COVID-19. The usual clinical course of hemodialysis patients with COVID-19 is not yet clear. We examined 5 hemodialysis patients with COVID-19 at our hospital and report, herein, the prolonged persistence of a positive result of the PCR test for SARS-CoV2 in hemodialysis patients.
Introduction:The clinical course of hemodialysis patients with COVID-19 still remains unclear.Methods: Thirty-four hemodialysis patients were retrospectively enrolled. Patients were divided according to disease severity, and clinical symptoms and laboratory data at admission were compared. Results:The serum C-reactive protein (CRP) level, D-dimer level, and white blood cell (WBC) count were significantly higher in the group with critical disease than in the group with mild to severe disease (p = 0.005, p = 0.039, and p = 0.045). The serum CRP level exceeded 10 mg/dl within 7 days of clinical onset in all the cases with critical disease. Conclusion:Hemodialysis patients with COVID-19 who have elevated serum CRP and D-dimer levels, and an elevated WBC count at admission and patients with serum CRP levels exceeding 10 mg/dl before day 7 after clinical onset should be carefully monitored for possible progression to critical disease.
Keywords: COVID 19, hemodialysis, D dimer, PCR test 〈Abstract〉 [Objective] Little is known about the clinical courses of hemodialysis patients with COVID 19. We examined the characteristics of COVID 19 in hemodialysis patients. [Materials and Methods] We enrolled 33 hemodialysis patients with COVID 19 and 174 non hemodialysis patients with COVID 19 who were admitted to our hospital in this study. We compared the clinical course of COVID 19 between the hemodialysis and non hemodialysis patients. Among the hemodialysis patients with COVID 19, we also compared the laboratory data of the severe and non severe groups. [Results] While 44.4% of the hemodialysis patients were treated with steroids, only 13.2% of the non hemodialysis patients received steroid treatment (p <0.001). Among the patients who were not treated with steroids, it took 10.3±3.2 days for fevers to resolve in the hemodialysis patients, which was significantly longer than in the non hemodialysis patients (8.0±3.6 days, p=0.034). In addition, it took 31.1±7.3 days for the hemodialysis patients to become PCR negative, which was significantly longer than it took in the non hemodialysis patients (21.7±4.4 days, p=0.016). The mortality rate among the dialysis patients was 12.1%, whereas none of the non hemodialysis patients died. The hemodialysis patients had a significantly worse prognosis than the non hemodialysis patients (p <0.001). Of the 4 deaths, thrombosis was suspected to be the cause of death in 2 cases. In a comparison between the severe and non severe cases, high C reactive protein (CRP) and D dimer levels and leukocyte counts and low lymphocyte ratios were seen in the severe group. [Conclusion] Among COVID 19 patients, more hemodialysis patients than non hemodialysis patients required
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